Recovery After Stroke: Personality And Behavior
Changes
Changes in emotions, feelings and
behavior are very common after a
stroke. Your brain has been injured,
and personality and behavior
changes can be a reflection of the
damage. Understanding and dealing
with these emotional issues are as
important
as
facing
physical
challenges during recovery.
Depression
Sadness
and
common feelings
they should not
“normal”
part
Depression can
moving forward
process.
depression
are
after a stroke, but
be considered a
of
recovery.
prevent you from
in your recovery
 Be familiar with the warning
signs of depression. People
who are depressed often talk
about feeling worthless and
tired. They may have
changes in their appetite and
weight, lose enjoyment in
usual activities, and attempt or
talk of suicide.
 If you suffer from depression,
get help from professional
counselors, stroke support
groups, and/or family
members.
Anger
Having a stroke can be an upsetting,
life-changing experience. So it’s not
surprising to learn that many stroke
survivors have feelings of anger and
selfishness after their stroke. Not
everyone who feels this way deals
with it the same. You may talk about
or act out your anger. Or you may
shut down your emotions and not
share your feelings with your loved
ones. You may not really even be
angry with others. It’s important to
remember that this behavior is a
result of the brain injury.
 Swearing, refusal, boasting, or
aggressive behavior are
problems for nearly one in five
stroke survivors.
 In a study of stroke survivors
who didn’t have a history of
depression, almost one third
were unable to control their
anger or aggression after the
stroke. Researchers believe
the behavior is more a result
of brain injury than of poststroke depression.
Mood Swings / Uncontrolled
Emotions
You may have rapid mood swings or
outbursts
of
uncontrolled
or
exaggerated emotion. This is known
as
emotional
labiality
or
psuedobulbar affect (PBA). If you
have PBA, the emotions you show
are not related or are out of
proportion to how you actually feel.
 PBA can cause impulsive,
uncontrolled emotional
reactions. You may burst into
laughter or tears, for no
obvious reason.
 The mood swings and
uncontrolled emotions usually
happen more often in the first
few months after your stroke
and then go away slowly over
time.
 Although PBA is often
confused with depression, it is
not. It is key to know the
symptoms of PBA and to not
mistake them for depression
or other psychiatric disorders.
Impulsivity
Behavioral changes vary depending
on how serious the stroke was and
where in the brain it took place. The
right side of your brain controls
emotions, how you communicate
when you aren’t talking (non-verbal
communication), and your sense of
your own body position (spatial
orientation). Damage to this part of
the brain can cause many emotional
issues, including an impulsive style
that can be dangerous.
 Stroke survivors who have
had strokes on the right side
of their brain don’t always
know how their brain is
damaged. If you have had a
right-brain injury, you may not
know that you cannot do the
things you could before the
stroke. You may also
experience short attention
span, short-term memory loss
and poor judgment.
 If you have an impulse, you
may be unable to hold back
from acting on a thought, such
as rising from a wheelchair
without checking to see if the
brakes are locked.
 What may help:
What Can I Do?
 Try to maintain a safe
environment
 Keep a day-to-day routine
 Have family members and
caregivers monitor your
activities
 Have family members and
caregivers give orders in
simple terms and repeat them
often
 Have family members and
caregivers point out the effects
of the stroke.
Dealing with the personality and
behavioral changes that accompany
stroke can be difficult for survivors,
caregivers and family members, but
help is available.
Memory Problems/Confusion
Some stroke survivors act as if they
remember things that in fact they do
not remember.
This is known
medically as “confabulation” and
should not be confused with
intentional lying.
In most cases, the “confabulation” is
the brain’s way to cope with memory
loss caused by stroke damage.
People who do this are confused.
 People who “confabulate” are
not deliberately lying or trying
to mislead. They are
genuinely unaware that their
memories are inaccurate.
 The problem sometimes
disappears over time.
 Ask your doctor about the best
treatments and medicines for
you.
 Talk to a professional
counselor if necessary.
 Get information on stroke
recovery from National Stroke
Association at www.stroke.org
or call (800) 787-6537, or
contact your local stroke
association.
 Join a stroke survivor support
group.
 Have your caregiver join a
caregiver support group, if
necessary.
Professionals Who Can Help
 Licensed mental health
professional
 General physician or doctor
Rehabilitation
is
a
lifetime
commitment and an important part of
recovering
from
your
stroke. Through rehabilitation, you
relearn basic skills such as talking,
eating, dressing and walking.
Rehabilitation can also improve your
strength,
flexibility
and
endurance. The goal is to regain as
much independence as possible.
Remember to ask your doctor
“Where am I on my stroke
recovery journey?”
Note: This fact sheet is compiled from general,
publicly available medical information and should
not be considered recommended treatment for any
particular individual. Stroke survivors should consult
their doctor about any personal medical concerns.
NSA publications are reviewed for scientific and medical
accuracy by the NSA Publications Committee.
© National Stroke Association, 2006
IP6 2/06